MEDICARE: DR. KIM ELAINE SCHMITT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	G161068	CA
2	207Y00000X	Otolaryngology Physician	ACS11006	AL
3	207Y00000X	Otolaryngology Physician	86917	GA

General Provider Information

NPI Number	:	1063486546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIM ELAINE SCHMITT MD

Provider Business Mailing Address
First Line	:	3855 PLEASANT HILL RD STE 420
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-8030
Country	:	US
Telephone Number	:	770-495-1955
Fax Number	:	770-232-9961

Provider Business Practice Location Address
First Line	:	3855 PLEASANT HILL RD STE 420
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-8030
Country	:	US
Telephone Number	:	770-495-1955
Fax Number	:	770-232-9961

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	04/20/2023

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